| Ascent Counseling & Dui Services | |
|
207 West Jefferson Street Suite 501 Bloomington IL 61701 | |
| (309) 828-1988 | |
| (309) 828-6540 |
| Full Name | Ascent Counseling & Dui Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 207 West Jefferson Street, Bloomington, Illinois |
| Authorized Official Name and Position | Richard W. Mast (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 3098281988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascent Counseling & Dui Services 207 W Jefferson St Suite 501 Bloomington IL 61701-3960 Ph: (309) 828-1988 | Ascent Counseling & Dui Services 207 West Jefferson Street Suite 501 Bloomington IL 61701 Ph: (309) 828-1988 |
| NPI Number | 1124250402 |
|---|---|
| Provider Enumeration Date | 08/20/2009 |
| Last Update Date | 03/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124250402 | NPI | - | NPPES |
| 104100000X | Other | IL | INSURANCE |
| 106H00000X | Other | IL | INSURANCE |
| 101Y00000X | Other | IL | INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.002048 (Illinois) | Primary |
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